BREAKTHROUGHS BLOG

February 27, 2013

“I’d be careful not to break something that would be hard to put back together,” Alan Magill—director of Malaria at the Bill & Melinda Gates
Foundation—said this week at the GHTC’s annual congressional briefing. Sequestration, just days away, was a primary concern for Magill and others
at the event, which focused on how US policymakers can protect the nation’s investments in global health research in upcoming budget discussions.

As Magill and others stressed, sequestration and federal budget cuts would severely hamper research taking place across the US government to develop new
vaccines, drugs, and other tools for global public health. According to moderator Lisa Cohen, executive director of the Washington Global Health Alliance,
more than 350 health innovations are in the research pipeline. She added that 200 of these are supported by the US government through agencies such
as the Centers for Disease Control and Prevention (CDC), the Department of Defense (DoD), the US Food and Drug Administration (FDA), the National Institutes
of Health (NIH), and the US Agency for International Development (USAID).

(from right to left) Lee Hall from the National Institute of Allergy and Infectious Diseases, Caroline Ryan from the President's Emergency Plan
for AIDS Relief, and Alan Magill from the Bill & Melinda Gates Foundation. Photo credit: PATH.

Widespread budget cuts would stop scientific progress in its tracks—progress that cannot be seamlessly picked up again if funding were to resume
in the future. “Many biomedical studies cannot survive cuts in funding in the middle of their work. It would be an irreversible mistake to halt these
ongoing global health research efforts,” Cohen said, adding, “Halting funding would mean that the world may never benefit from these tools that are
so close to development and delivery.”

As the panelists stressed, there are several compelling humanitarian reasons to protect US investments in global health research. “Scientific advancements
have brought us to a tipping point in the fight against HIV/AIDS,” Caroline Ryan, deputy coordinator for Technical Leadership at the President’s Emergency
Plan for AIDS Relief (PEPFAR) said. She added that “science has set us on a new path—a path to achieving an HIV-free generation.”

Lee Hall, chief of the Parasitology and International Programs Branch at the National Institute of Allergy and Infectious Diseases, said that the NIH is
supporting research for an array of new, lifesaving health tools—including drugs, diagnostics, and vaccines for malaria, Chagas disease, and
tuberculosis. “We’re standing at a very promising moment,” Hall said. “Looking at what’s on the horizon, it’s clear that a lot will come out of our
support for global health research. We need new tools if we are to realize the benefits of US support for global health.”

Speakers also emphasized that there are countless domestic benefits that come with US investments in global health research. “We live in a globalized world,
whether we like it or not,” Magill said. “This presents us with the choice to exert America’s leadership role and shape the world how we’d like to
see it—or let someone else do it for us.” Magill added that with the ease and speed of airline travel, “what’s happening in the middle of Africa
today could be happening at Dulles tomorrow.” Hall also highlighted that many areas in the United States are vulnerable to tropical infections, and
that diseases like Chagas are appearing throughout some Southwestern states.

Throughout the event, all three panelists underscored the importance of partnerships to advancing research and science for new health tools. According
to Ryan, PEPFAR “gets more bang for our buck” by working in partnerships with other US agencies, such as the NIH and FDA, as well as philanthropic
groups like the Gates Foundation. As an example, Ryan cited that PEPFAR and USAID are supporting the development of microbicides with a research infrastructure
established by the NIH.

Hall also cited NIH’s numerous partnerships with US academic institutions, nonprofit groups, and other federal agencies like the CDC and DoD. Magill stressed
that from the Gates Foundation’s perspective, the US government is a critical partner in global health. “The Bill & Melinda Gates Foundation can
only provide a small fraction of what the US can bring to the table,” he said, adding that investments in global health research should not only be
seen as humanitarian aid—they are investments in science that provide “a lot bang for a little buck. We should save programs that are investments
in the future.”